I see where, today, the Governor of KY signed a bill that will allow APRNs to prescribe independently after they have practiced under a collaborative practice agreement for four years. I think the new KY law is a step in the right direction.Still, it only tinkers with change at the perimeter of the problem.Thus, it can also be viewed as a holding action.That is, it can be viewed as something that takes some of the steam out of APRN’s cries of foul play and their complaints about the patent injustice of state governments supporting and upholding the monopolistic condescending, paternalistic attitude the medical profession exercises towards APRNs and the public welfare to the disadvantage of the public as well as APRN’s.

One of the reasons the new act may be viewed as nothing more than a political ploy bereft of any real concern about public safety is the fact that it does not include experienced APRNs as qualified to enter into Collaborative Practice Agreements with new graduates.If safety were the primary motivation behind the requirement that APRN’s practice four years, it wouldn’t be limited to practice under a medical doctor.Instead it would include practice under experienced APRNs or MDs; or, it would exempt new grads that had undergone a residence in prescribing.

My APRN has more than 15 years of experience and supervised/preceptored medical students along with myself; yet; the moment they are licensed, the government treats the new MDs as if they are superior practitioners compared to the APRN with over 15 years of practice. I’m sure the new MDs know some things that the highly experienced APRN doesn’t know; but I’m equally sure that he would out- perform them in the diagnosis and management of psychiatric mental health patients any day of the week!

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If it wasn't so late I would have a lot more to say, but I certainly think you have pointedly and poignantly hit the proverbial nail on the head! I was told to "be 'grateful' for the small steps, we are moving in the right direction! " I couldn't disagree more ! I am insulted! I have been in psych since. 1985 and psych CNS / Aprn since 1992! You are exactly right! I helped to train and have many more years experience than an individual I might have to pay a large monthly sum to be my collaborative MD for controlled substances. I'm very judicious about what I prescribe and find it fascinating that the very reason given for us to have this requirement is to help manage the inappropriate prescribing of controlled substances. The data is public knowledge / those abuse a were written by MD's bc APRN's could not prescribe controlled substances! That's insanely unbelievably! The quintessential Fox guarding the henhouse !